adjustment
Expectation and Pain
07/12/11 11:32 Filed in: From the Research
I have written previously about the role that expectation plays in clinical practice. Indeed, mastering 'expectation management' is a core part of effective 'doctoring' and can easily make the difference between the success and failure of most forms of treatment, particularly when pain is involved. But there's more to this phenomenon than simply recognising the possibility of placebo analgesia. Recent studies have shown that a patient's expectation of treatment success influences their nociceptive system all the way from the cortex to the brainstem and spinal cord...
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What Does an Adjustment Do?
05/05/11 12:03 Filed in: From the Research
One of the most common questions that we are asked is, "What does an adjustment actually do?"
Every chiropractor would be aware of the most common theories regarding spinal manipulation and how it exerts its effects upon the human body. However, the detail is often somewhat sketchy. Fortunately the research literature is increasingly building a body of evidence as to the mechanics of manual treatment and how it is transduced into neurological effects. Some of these seem well understood; the analgesic effects occurring at the dorsal horn, the increased sympathetic activity following mobilisation, changes in joint perception and proprioception, and altered patterns of muscle recruitment. We have discussed this last item recently, specifically the changes to multifidus muscle activity that arise following a spinal adjustment, and it has returned again as the subject of a new study published in Journal of Orthopaedic & Sports Physical Therapy...
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Every chiropractor would be aware of the most common theories regarding spinal manipulation and how it exerts its effects upon the human body. However, the detail is often somewhat sketchy. Fortunately the research literature is increasingly building a body of evidence as to the mechanics of manual treatment and how it is transduced into neurological effects. Some of these seem well understood; the analgesic effects occurring at the dorsal horn, the increased sympathetic activity following mobilisation, changes in joint perception and proprioception, and altered patterns of muscle recruitment. We have discussed this last item recently, specifically the changes to multifidus muscle activity that arise following a spinal adjustment, and it has returned again as the subject of a new study published in Journal of Orthopaedic & Sports Physical Therapy...
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Expectation and Outome
14/08/10 13:50 Filed in: From the Research | Observations from the Field
As chiropractors we naturally possess confidence in the effectiveness of a spinal adjustment. Indeed, with an understanding of the neurological underpinnings of our art it is neither surprising nor unjustified that we look for scientific data to support our observations and theories. But as we dig beneath the surface of human physiology we come up against evidence that shows that our clinical successes might have just as much to do with the patient as they do with us.
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What Are You Adjusting? Hyper or Hypo?
03/06/10 11:22 Filed in: From the Research | Clinical Pearls
To most chiropractors quality of spinal motion is a prerequisite for spinal health. We have an intrinsic understanding that a joint must move normally to be normal - or at least to stay that way. As such, our examinations are heavily geared towards assessing and quantifying the relative motion of each segment. We then give it a rating: 'normal', 'hypermobile' or 'hypomobile'.
Most of the time chiropractors tend to focus upon finding areas of limited motion - segments of greater stiffness that would benefit from an adjustment. Indeed, the majority of definitions of joint dysfunction suggest that reduced mobility is a cardinal sign, and that we should try to stay away from any hypermobile segment.
But is this really what's going on? Is it truly the stiffer joints that are the prime source of pain in most of our patients? And is it the stiffer joints that benefit the most from manipulation? Or could it actually be the hypermobile joints that should be the target of, and beneficiaries of, the neurological effects of an adjustment?
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Most of the time chiropractors tend to focus upon finding areas of limited motion - segments of greater stiffness that would benefit from an adjustment. Indeed, the majority of definitions of joint dysfunction suggest that reduced mobility is a cardinal sign, and that we should try to stay away from any hypermobile segment.
But is this really what's going on? Is it truly the stiffer joints that are the prime source of pain in most of our patients? And is it the stiffer joints that benefit the most from manipulation? Or could it actually be the hypermobile joints that should be the target of, and beneficiaries of, the neurological effects of an adjustment?
Read More...